Who are all these public health people supposedly arguing for no one to go anywhere or do anything ever, that mean we need so many “think” pieces condemning that?
The public health people I know want governments to step up and address this pandemic like a grown-up.
How? A🧵
Acknowledging that public health is a *public* responsibility & not an individual choice or about individual risk management.
Articulating a clear goal & listening to public feedback on it.
Designing & funding a robust data collection system. Specifying on-ramps *and* off-ramps for extra precautions.
Sustainably increasing public health & health care workforces and capacity.
Addressing access barriers to vaccines & health care.
This must include health care for chronic conditions that *pre-dispose* people to poor COVID outcomes AND for chronic conditions that are *consequences* of COVID.
Expanding & improving internet access to all areas to allow remote work as a continuing option for those who prefer it.
Massively upgrading the infrastructure of the nation’s schools, including water, sanitation, and ventilation, plus better outdoor spaces.
Developing sustainable remote schooling options for THOSE kids who have thrived with at-home learning.
Creating & enforcing improved workplace safety standards to protect workers from COVID and to ensure rapid update in future pandemics of other diseases.
Improve and expand contact tracing to include reverse tracing & identify where infections occurred to allow control measures.
Addressing the problems of limited sick leave & presenteeism, which encourage people to work while sick, including a plan to ensure quarantine is possible and people are financially & materially supported during quarantine and isolation.
Incentivize creative re-thinking of higher risk activities by providing grants to businesses to try out transmission-limiting ideas, and assessing effectiveness.
Encouraging localities to support re-zoning that allows for more public outdoor space & commercial outdoor space.
Fund ^well-designed^ research into Long COVID, involving patients in identifying the key questions that are most pressing for their daily functioning and longer term health and happiness.
This last one is for the media, not gov’t: y’all need to stop platforming “anti-public health” rhetoric & start platforming actual public health.
Each & every “what public health got wrong” article is further prolonging this disaster by placing the blame on the wrong target.
None of these are new ideas. All of these are things that public health professionals have been calling for since the start of this pandemic.
Most are things public health professionals were warning, pre-pandemic, we needed in order to *prevent* pandemics.
It’s time to listen.
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At the end of Jan / beginning of Feb, my hypothesis was that if there wasnt a clear national surge by the end of March we would be basically surge-free until the fall.
My original prediction built on these ideas: 1) Prior summer waves in the US were largely regional 2) Regions with summer waves spent summer mostly indoors 3) People would be outdoors more in many regions come spring 4) Spring/summer weather may be less conducive to transmission
Those were my prior beliefs, but even by Feb there was evidence that they weren’t all supported by data.
Many of you pointed to the UK 2nd surge, during early Spring, as evidence that Spring weather & going outdoors wouldnt be protective.
I saw someone say that much of what we see as scary about polio is actually “long polio” & tbh that’s pretty true.
I think the “long” framing makes it clear long COVID isn’t unprecedented & that we need to face up to it.
What other long infectious diseases are there?
A list*
*Thread disclaimer: obviously not all cases of all of the diseases in the following tweets share the exact same cause, because very few diseases have only one single cause (tho a few do!)
The diseases below are those that CAN be caused by infections with the pathogens listed.
Rheumatic heart disease ==> long strep throat / long scarlet fever